With the norms of the National Medical Commission (Foreign Medical Graduate Licentiate) Regulations 2021 coming to the fore, foreign medical graduates (FMGs) need to follow certain strictures to practise on native soil. Evidently the norms will apply only to Indian students who have gone abroad to study MBBS after November 18, 2021 (which is when the Regulations came into force) and going by their numbers (of nearly8,000 to 10,000 each year) to some of the countries where medical education is said to be more affordable, the students may need to rethink their options.

Course of study

As per the Regulations, the entire course, training and internship or clerkship has to be done outside India, in the same medical foreign medical institution throughout the course of study and no part of medical training and internship can be done in any other country other than the country from where the primary education is being obtained. This raises questions on the fate of the Ukraine-returned MBBS students who are forced to stay on in India and seek options both within and outside the country. “The government and regulatory bodies may take a call in providing appropriate training in such extraordinary circumstances, even if it means accommodating the students either in India or abroad, provided the institutions under consideration, have adequate seats and it does not alter the quality of medical education,” says Dr Pawanindra Lal, director professor & HOD, Maulana Azad Medical College (MAMC), New Delhi.

Taking responsibility

Considering the NMC Regulation also emphasises that a foreign graduate can practice in India only when he.she is registered with the respective professional regulatory body of the country from where he.she has obtained the degree, Dr Lal says, the decision is justifiable. “Wherever a student goes for MBBS, the student should get a degree that should enable him.her to practise in that country. If that is lacking, the country may shrug off the responsibility of producing a good quality doctor.”

License to practice

Dr Lal explains further, “If students come to India with a view to practise and appear for National Exit Exam (NExT) or any other mandated test.s by NMC, it is because India is their home country, and the countries where they go to study have agreed to provide medical education and nothing beyond it. The Regulations are a means to provide a reality check on the quality of training overseas should students embark on foreign shores.”

While citing the norms in place to qualify for the United States Medical Licensing Examination (USMLE), Dr Lal says it involves a mix of theory and clinical examinations. “The Foreign Medical Graduate Examination (FMGE) on the other hand is theory-based, hence less challenging, but the qualifying results of less than 30% is far from encouraging, which signifies that the quality of education imparted to students in such cases may not match up to the required standards.”

Quality control

According to Dr Manoj Andley, Lady Hardinge Medical College, New Delhi, the MBBS training imparted to students abroad is “more theoretical in nature which is why the measures have become more stringent”.

“The Indian medical students on the other hand, are exposed to patient care, get a feel of how treatment is conducted, watch their seniors make diagnosis and prescribe treatments as they are rotated through various wards and departments, right from out-patient clinics to operation theatres. The FMGs are expected to have similar type of exposure,” Dr Andley says, elaborating there is no harm in encouraging more students to join the medical profession, as long as the quality of medical education and doctors is not compromised.

Driven by passion

Neha Jayaprakash Shamleela (22) from Palakkad, Kerala, was drawn to Ukraine because of its “affordability and ambience”. Busy with her online classes, Neha’s aim is to complete six years of medical education for which she has a temporary residence permit. “I had gone to study at Bogomolets National Medical University, Kyiv, with a passion to be a doctor. As per our syllabus, we will have clinical practice from third year onwards. I am not too keen to look at the norms as they keep changing every few years. For instance, until 2018, it was not mandatory to clear NEET to undertake medical education overseas, so who knows what the future will hold six years from now,” says the first year MBBS student whose father is a UAE businessman and mother a homemaker.